Dietary diversity and micronutrient intake in women in North West UK and North West Pakistan: the impact of phytate

Abstract

Micronutrient malnutrition continues to be the major public health problem globally, especially in South Asian (SA) countries including India, Pakistan, Bangladesh (Akhtar et al.,2013, Tidemann-Andersen et al., 2011). Currently, global statistics indicate a widespread increase in iron, zinc, vitamin A deficiencies among vulnerable populations(Sharma, 2003) Also, it is important to consider the bioavailability of micronutrients from the diet (Frontela et al., 2011) as cereal based staple diets consumed in SA countries contain high amount of phytates, which are known for inhibiting micronutrient absorption. Considering this, the purpose of the present study was to assess dietary diversity among SA women in northwest UK (NW UK) and northwest Pakistan (NW PK), along with investigating the amount of micronutrients (iron, zinc) and inhibitory phytates present in the flour used to make dietary staples from both the study locations. In addition, the micronutrient status (iron and zinc) of women in NW PK was assessed.
Dietary data from 40 female participants (18-30 years) from NW PK and 15 participants (18-30years) was obtained using three 24 hour dietary recalls. These were used to calculate the dietary diversity score for the women (WDDS). Wheat flour samples obtained from both the geographical regions and these were analysed for their iron and zinc content by atomic absorption spectrophotometry and for total phytate content by a spectrophotometric method. Finally to explore micronutrient status of women, blood samples were obtained for the participants in NW PKand analysed for haemoglobin and plasma zinc concentration.
The results revealed that the WDDS for participants across two study regions were significantly different (p<0.05), with those in the UK having a significantly higher WDDS (range: 4.33-5.06 in the UK vs 2.55-3.02 in PK). Analysis of flour samples revealed that thephytate content of the flour used in the PK community ranged from 230 – 565 mg/100g. This is comparable in terms of phytate content to flour obtained from SA shops in NW UK, which ranged from 273 mg/100g for white flour to 584 mg/100g for wholemeal flour. The average iron and zinc content of the PK flour was also similar to that of wholemeal flour purchased in the UK. Biochemical measures of zinc and iron status of the NW PK women revealed they are likely to be deficient in both of these trace minerals.
In conclusion, the study highlighted the paucity of the diet consumed by SA women living in NW PK compared with that of SA women living in NW UK. The low dietary diversity, particularly the infrequent consumption of meat or fish, is likely to have contributed to the poor micronutrient status of the PK women. Strategies to improve this could include demonstration kitchens to provide basic nutritional information on how to make best use of available, affordable foods in order to improve dietary diversity in this community.